Cognitive Analytic Therapy for Obsessive Morbid Jealousy: A Case Series

Published on Dec 1, 2018in Journal of Psychotherapy Integration
· DOI :10.1037/INT0000122
Louise Curling2
Estimated H-index: 2
(University of Sheffield),
Stephen Kellett28
Estimated H-index: 28
(University of Sheffield),
Peter Totterdell45
Estimated H-index: 45
(University of Sheffield)
The evidence base for integrative forms of psychotherapy for obsessive morbid jealousy (OMJ) is very limited and so this study sought to examine the effectiveness of cognitive analytic therapy (CAT) in a small case series. Three A/B with extended follow-up single case experimental designs (SCEDs) were completed, with 1 male and 2 female patients presenting with OMJ. Results indicate that on the daily ideographic jealousy measures (across and within each case) there was evidence of significant reductions in morbid jealousy (and other associated symptoms) during the treatment phase. Treatment effects were also seen to be maintained over the follow-up period in these ideographic measures. On the primary nomothetic measure, all cases were classed as "nonjealous" by follow-up. Partner violence was extinguished across all cases. This article provides evidence of CAT offering promise as a suitable OMJ treatment option. Methodological limitations, theoretical insights, and treatment implications are all discussed.
Figures & Tables
📖 Papers frequently viewed together
1 Citations
7 Citations
7 Citations
#1Louise Curling (University of Sheffield)H-Index: 2
#2Stephen Kellett (University of Sheffield)H-Index: 28
Last. Katherine Berry (University of Manchester)H-Index: 33
view all 6 authors...
OBJECTIVE: The evidence base for the treatment of morbid jealousy with integrative therapies is thin. This study explored the efficacy of cognitive analytic therapy (CAT). DESIGN: An adjudicated hermeneutic single-case efficacy design evaluated the cognitive analytic treatment of a patient meeting diagnostic criteria for obsessive morbid jealousy. METHOD: A rich case record was developed using a matrix of nomothetic and ideographic quantitative and qualitative outcomes. This record was then deba...
6 CitationsSource
#1Stephen Kellett (University of Sheffield)H-Index: 28
#2Mel Simmonds-Buckley (University of Sheffield)H-Index: 4
Last. Peter Totterdell (University of Sheffield)H-Index: 45
view all 3 authors...
The evidence base for treatment of hypersexuality disorder (HD) has few studies with appropriate methodological rigor. This study therefore conducted a single case experiment of cognitive analytic therapy (CAT) for HD using an A/B design with extended follow-up. Cruising, pornography usage, masturbation frequency and associated cognitions and emotions were measured daily in a 231-day time series. Following a three-week assessment baseline (A: 21 days), treatment was delivered via outpatient sess...
4 CitationsSource
#1Raul Berrios (University of Sheffield)H-Index: 7
#2Stephen Kellett (University of Sheffield)H-Index: 28
Last. Marisa PoggioliH-Index: 1
view all 4 authors...
here are few brief measures of identity disturbance for use in clinical practice that have been subject to any cross - culturally validation . This study investigated the construct validity of the Personality Structure Questionnaire (PSQ) in Italian clinical (N=237) and community ( N=296) samples . Confirmatory factor analysis was conducted to investigate the internal structure of the PSQ. A three – factor structure (i.e., differing self - states, mood variability and behavioral loss of control)...
9 CitationsSource
#1Patricia A. Alexander (UMD: University of Maryland, College Park)H-Index: 67
#2Denis Dumas (UMD: University of Maryland, College Park)H-Index: 14
Last. Carla M. Firetto (PSU: Pennsylvania State University)H-Index: 9
view all 5 authors...
Relational reasoning is the foundational cognitive ability to discern meaningful patterns within an informational stream, but its reliable and valid measurement remains problematic. In this investigation, the measurement of relational reasoning unfolded in three stages. Stage 1 entailed the establishment of a research-based conceptualization of the construct and the development of a corresponding Test of Relational Reasoning (TORR). Stage 2 focused on the reliability and validity of data from th...
43 CitationsSource
#1Rachel Calvert (University of Sheffield)H-Index: 3
#2Stephen Kellett (University of Sheffield)H-Index: 28
Purpose This study reviews the quality of the extant outcome evidence for cognitive analytic therapy (CAT) to inform clinical practice and to stimulate a future CAT research strategy. Method An electronic search identified CAT efficacy and effectiveness studies and these were subject to systematic review. The methodological quality of studies meeting inclusion criteria were appraised using two validated research study quality checklists and studies were fitted to an established model of psychoth...
27 CitationsSource
#1Anthony RyleH-Index: 20
#2Stephen KellettH-Index: 28
Last. Rachel CalvertH-Index: 3
view all 4 authors...
Cognitive analytic therapy (CAT) was formalised in 1984 by Anthony Ryle. It facilitated the clinical integration of psychodynamic therapy and personal construct/cognitive psychology. It is a brief, user-friendly relational therapy, applicable to the wide range of psychological problems typically seen in public mental health settings. It has recently been included in national guidelines for the treatment of personality disorder in the National Health Service. CAT provides a coherent model of deve...
26 CitationsSource
#1Borjanka BatinićH-Index: 5
#2Dragana DuišinH-Index: 8
Last. Jasmina BarišićH-Index: 5
view all 3 authors...
Although obsessive jealousy is a highly disturbing disorder, frequently it goes unrecognized, as most attention is paid to delusional jealousy, being the more prominent clinical phenomenon. In order to distinguish obsessive from delusional jealousy, the basic clinical characteristics of these two types of jealousy are presented, as well as the mechanism of their respective genesis, and the differences which we must be aware of in order to prevent misdiagnosis and consequent wrong treatment choic...
13 Citations
#1Stephen Kellett (University of Sheffield)H-Index: 28
#2Peter Totterdell (University of Sheffield)H-Index: 45
Objectives. Credible evaluations of the psychological treatment of morbid jealousy are rare. The aim of this study was to evaluate temporal responsivity to cognitive behavioural therapy (CBT) and cognitive analytic therapy (CAT) for morbid jealousy. Design. The methodology involved matched A/B single-case experimental designs (SCED) with extended follow-up, in which two patients and their partners completed daily jealousy target symptom items across the phases of the study. Patients also complet...
11 CitationsSource
#1Brad J. Sagarin (NIU: Northern Illinois University)H-Index: 24
#2Amy L. Martin (NIU: Northern Illinois University)H-Index: 2
Last. Bettina Zengel (NIU: Northern Illinois University)H-Index: 8
view all 7 authors...
The theory of evolved sex differences in jealousy predicts sex differences in responses to sexual infidelities and emotional infidelities. Critics have argued that such differences are absent in studies that use continuous measures to assess responses to hypothetical infidelities or in studies that assess responses to real infidelities. These criticisms were tested in two random-effects meta-analyses of 40 published and unpublished papers (providing 209 effect sizes from 47 independent samples) ...
88 CitationsSource
#1Michael Barkham (University of Sheffield)H-Index: 87
#2William B. Stiles (Miami University)H-Index: 90
Last. John Mellor-ClarkH-Index: 25
view all 4 authors...
Objectives. The question of how effective therapies are in routine practice is crucial. The answer depends on how we define effectiveness. Both the definition of who was treated and the index chosen to represent outcome can affect estimates dramatically. Design. We used data from the Clinical Outcomes in Routine Evaluation (CORE) Primary Care National Practice-Based Evidence database-2005 on the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) from 33,587 patients and examined r...
43 CitationsSource
Cited By3
#1Stephen Kellett (University of Sheffield)H-Index: 28
#2Daniel Stockton (University of Sheffield)H-Index: 2
This paper evaluates the effectiveness of 8-sessions of cognitive analytic therapy (CAT) for obsessive morbid jealousy (OMJ). The evaluation method was a mixed-methods A/B with follow-up single-cas...
#1Dick P. H. Barelds (UG: University of Groningen)H-Index: 21
#2Pieternel DijkstraH-Index: 25
#1Craig Hallam (University of Liverpool)H-Index: 1
#2Melanie Simmonds-Buckley (University of Sheffield)H-Index: 3
Last. Andrew Jones (University of Liverpool)H-Index: 25
view all 5 authors...
OBJECTIVES This paper sought to conduct a meta-analysis of the effectiveness and durability of cognitive analytic therapy (CAT) and assess the acceptability of CAT in terms of dropout rates. DESIGN Systematic review and meta-analysis. METHODS PROSPERO registration: CRD42018086009. Searches identified CAT treatment outcome studies eligible to be narratively synthesized. Pre-post/post-follow-up effect sizes (ESs) were extracted and synthesized in a random-effects meta-analysis. Variations in effec...
4 CitationsSource
#1Rebecca Tyrer (Oxford Health NHS Foundation Trust)H-Index: 1
#2Ciara Masterson (University of Leeds)H-Index: 3
Case formulation is considered important in both the development of the therapeutic relationship and in starting the process of therapeutic change. Cognitive analytic therapy describes the developmental origins and maintenance of a client's problems in both written (reformulation letter) and diagrammatic form (Sequential diagrammatic reformulation; SDR). This study aimed to investigate the effects of these reformulation tools on insight and symptom change. A small‐N repeated measures design was ...
2 CitationsSource
#1Stephen Kellett (University of Sheffield)H-Index: 28
#2Corrie StocktonH-Index: 1
Last. Jaime Delgadillo (University of Sheffield)H-Index: 20
view all 6 authors...
Abstract Background Narrative reformulation (NR) is a component of cognitive analytic therapy (CAT) that is assumed to increase client engagement and improve clinical outcomes. This study set out to test these claims. Methods A single-blind randomized and controlled dismantling trial investigated treatment outcomes for moderate to severely depressed patients receiving CAT in Primary Care. Ninety-five participants were randomized to either full-CAT (n = 52) or CAT minus narrative reformulation (C...
7 CitationsSource